Abstract
INTRODUCTION: Upper limb soft tissue sarcomas are extremely rare and can be misdiagnosed as benign, leading to unplanned excisions. Unplanned excisions and local recurrences pose significant challenges for the subsequent treatment of patients. PRESENTATION OF CASE: A patient with a forearm soft tissue sarcoma who underwent unplanned excisions and experienced multiple recurrences. In the most recent treatment, she underwent wide tumor excision combined with thigh free flap transplantation for reconstruction. The reconstruction surgery successfully addressed the extensive soft tissue defect. During the three-year follow-up, there was no tumor recurrence observed, alongside the restoration of upper arm function. DISCUSSION: Challenges and considerations in the treatment of soft tissue sarcomas (STS) are discussed. CONCLUSION: Unplanned excisions and local recurrences of upper limb soft tissue sarcomas present significant challenges for surgery. Patients should be referred to specialized cancer centers for multidisciplinary diagnosis and treatment.